When to Expect Accutane to Start Working?

Accutane will usually start to work within the first 1-2 months, but some patients will actually worsen during this initial phase, and this is normal too. Each patient will have a different experience, and very few patients are still breaking out towards the end of their treatment. When a patient is still experiencing breakouts there are few options to what can be done: we can finish the 6 months, take a 3 month break, then resume another course, or we can extend the treatment beyond the 6 months (and this is dependent on you Doctor's clinical judgement), and we can consider other reasons for why a break out is still occurring, we should consider a hormonal component if the patient is female which can also be treated successfully.While on Accutane, I would only use gentle facial cleansers, avoid using any acne topical therapies, avoid supplemental Vitamin A, and use sun protection daily, and do not forget to use a good lip balm several times per day.Good luck, Dr. P.

In the first month of treatment on Accutane you may notice a worsening of acne. This is expected and it's really a function of Accutane causing "epidermal and sebaceous maturation". Most patients start to notice clearing about a month after starting Accutane and it continues through the course.
As far as preventative measures: make sure to use an oil-free non-comedogenic moisturizer and sunblock everyday along with emolliating lip balm such as Aquaphor. 
Good luck!